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Open Access 01-12-2015 | Viewpoint

PEEP titration during prone positioning for acute respiratory distress syndrome

Authors: Jeremy R. Beitler, Claude Guérin, Louis Ayzac, Jordi Mancebo, Dina M. Bates, Atul Malhotra, Daniel Talmor

Published in: Critical Care | Issue 1/2015

Abstract

No major trial evaluating prone positioning for acute respiratory distress syndrome (ARDS) has incorporated a high-positive end-expiratory pressure (high-PEEP) strategy despite complementary physiological rationales. We evaluated generalizability of three recent proning trials to patients receiving a high-PEEP strategy. All trials employed a relatively low-PEEP strategy. After protocol ventilator settings were initiated and the patient was positioned per treatment assignment, post-intervention PEEP was not more than 5 cm H₂O in 16.7 % and not more than 10 cm H₂O in 66.0 % of patients. Post-intervention PEEP would have been nearly twice the set PEEP had a high-PEEP strategy been employed. Use of either proning or high-PEEP likely improves survival in moderate-severe ARDS; the role for both concomitantly remains unknown.

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Title: PEEP titration during prone positioning for acute respiratory distress syndrome
Authors: Jeremy R. Beitler
Claude Guérin
Louis Ayzac
Jordi Mancebo
Dina M. Bates
Atul Malhotra
Daniel Talmor
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: Critical Care / Issue 1/2015
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/s13054-015-1153-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

PEEP titration during prone positioning for acute respiratory distress syndrome

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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